This patient developed breast cancer and underwent bilateral skin sparing mastectomies through horizontal ellipse incisions. Dr. Geiger performed immediate prepectoral (on top of the muscle) reconstruction with tissue expanders. The tissues were stretched as she completed chemotherapy. She later underwent exchange to the latest generation, highly cohesive (gummy bear) shaped, textured silicone implants. This created a more natural shape and an overall excellent appearance in addition to the treatment of her cancer.